| NPI | 1700955390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX J0164) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX J0164) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2019-01-27 |