| NPI | 1639149362 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX F9615) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX F9615) | 
| Enumeration Date | 2006-01-25 | 
| Last Update Date | 2007-08-09 |