| NPI | 1730162025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4423) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2007-00167) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2021-10-13 |