| NPI | 1053585349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q7362) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: TX Q7362) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2025-04-24 |