| NPI | 1417382474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILY WOLDU Member 832-331-8450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-09-11 |