| NPI | 1407149057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4294) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10039970/55796) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2014-10-09 |