| NPI | 1063908093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T3197) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10063384) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2026-01-14 |