| NPI | 1619098852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N2515) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 225024) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2011-06-03 |