| NPI | 1548240799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX L1765) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L1765) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: TX L1765) | |
| Enumeration Date | 2006-01-21 |
| Last Update Date | 2013-02-28 |