| NPI | 1861719593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R2176) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD161951) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2017-12-12 |