| NPI | 1780979542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P6773) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10039506) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2019-03-20 |