| NPI | 1760869135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R6528) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TN 59170) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: TN 59170) | |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2019-05-25 |