| NPI | 1407018559 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q0996) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 710) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2021-06-10 |