| NPI | 1356609150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S9093) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 261904) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2023-10-05 |