| NPI | 1487965646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P5742) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 550086) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2014-03-14 |