| NPI | 1922427624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R5761) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 260847) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2018-04-25 |