| NPI | 1639135866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L1892) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: TX L1892) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-06-16 |