| NPI | 1639581911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S3679) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 308433) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2020-01-09 |