| NPI | 1952531394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q3910) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX Q3910) |
| 208600000X Surgery (Licence: TN 51137) | |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2023-07-03 |