| NPI | 1598754194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX K8919) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MS 17735) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2010-08-17 |