| NPI | 1972609162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L1124) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: TX L1124) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2019-10-29 |