| NPI | 1518967652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX K3915) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX K3915) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2015-06-02 |