| NPI | 1568447431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L4626) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA L14280R) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2009-02-06 |