| NPI | 1821121112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M7795) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2006-01913) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2014-12-12 |