| NPI | 1639455140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4977) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX bc57583870310) |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2024-06-26 |