| NPI | 1730384405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P0860) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2009-00429) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2021-01-07 |