| NPI | 1619133774 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P1781) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P1781) | 
| 207P00000X Emergency Medicine (Licence: MO 2019033226) | |
| Enumeration Date | 2008-07-29 | 
| Last Update Date | 2020-10-14 |