| NPI | 1811937212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P1412) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2005-01682) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2022-04-04 |