| NPI | 1699062190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX R4714) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A131097) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2018-03-17 |