| NPI | 1023090685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MS 31562) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TN 28553) |
| 207Q00000X Family Medicine (Licence: TX L8014) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2025-06-30 |