| NPI | 1649382979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L9766) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX L9766) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-09-20 |