| NPI | 1073905097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: TX v3505) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TX V3505) |
| 207P00000X Emergency Medicine (Licence: TX V3505) | |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2026-09-05 |