| NPI | 1922176676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R1744) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101239814) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2021-09-23 |