| NPI | 1689835936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2011-01382) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10032241) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2017-04-06 |