| NPI | 1457611709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q0328) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP1-0044180) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2019-12-31 |