| NPI | 1437253622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K8250) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 19654) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2013-05-06 |