| NPI | 1730346826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X (Licence: TX Q2757) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 252279-1) |
| 208600000X Surgery (Licence: NY 252279-1) | |
| Enumeration Date | 2008-05-18 |
| Last Update Date | 2016-06-29 |