| NPI | 1912387556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R3521) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10054210) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2022-04-13 |