| NPI | 1043847452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD215017) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 12439698-1205) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2026-04-21 |