| NPI | 1407054646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q1029) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 2515) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2021-05-05 |