| NPI | 1336147701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L5397) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L5397) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2021-12-14 |