| NPI | 1568760981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q2341) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 65716) |
| Enumeration Date | 2011-03-09 |
| Last Update Date | 2015-11-19 |