| NPI | 1457471419 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M8491) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 13735) | 
| Enumeration Date | 2007-03-30 | 
| Last Update Date | 2021-06-17 |