| NPI | 1558546572 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX N1047) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N1047) | 
| Enumeration Date | 2008-01-09 | 
| Last Update Date | 2018-01-22 |