| NPI | 1972705754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P5930) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 201659) |
| 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX P5930) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2015-10-21 |