| NPI | 1568552628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S4847) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9900553) |
| 207Q00000X Family Medicine (Licence: IA 9900553) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-03-09 |