| NPI | 1811126295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q5130) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q5130) |
| 207Q00000X Family Medicine (Licence: IA 39722) | |
| 207Q00000X Family Medicine (Licence: MO 2012026106) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2024-03-07 |