| NPI | 1720498124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R4381) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP-10050700) |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2021-07-09 |