| NPI | 1487893525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R0249) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 25823) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2017-02-10 |