| NPI | 1578542973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX G7607) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX G7607) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2012-12-06 |