| NPI | 1811254626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q9324) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD H0087958) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2019-08-15 |