| NPI | 1376837013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P9156) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10039972) |
| Enumeration Date | 2011-05-29 |
| Last Update Date | 2016-04-04 |