| NPI | 1689101677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S4920) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S4920) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2021-01-19 |