| NPI | 1730162645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N3841) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 203805) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2019-06-20 |