| NPI | 1689869117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S7952) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101242850) |
| 207Q00000X Family Medicine (Licence: TX 42512) | |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2020-08-26 |