| NPI | 1699152033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q1884) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 5796) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2018-07-02 |