| NPI | 1073798690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T4515) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 52990) |
| Enumeration Date | 2008-01-02 |
| Last Update Date | 2025-03-14 |