| NPI | 1508861477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 4796206-1205) |
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: UT 4796206-1205) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2015-12-15 |