| NPI | 1407039753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N1130) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX N1130) |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2011-12-13 |