| NPI | 1508019001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N9153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10031925) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2020-07-15 |