| NPI | 1902991953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N7652) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 102694) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2013-03-06 |