| NPI | 1780762823 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R3468)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E4816)  | 
| Enumeration Date | 2006-11-02 | 
| Last Update Date | 2017-09-26 |