| NPI | 1376739474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N7876) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2009-0635) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2024-01-18 |