| NPI | 1386842771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P1250) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R8204) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: TX P1250) | |
| Enumeration Date | 2007-07-06 |
| Last Update Date | 2016-08-11 |