| NPI | 1730112236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P7699) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 200190) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2014-06-10 |