| NPI | 1083996177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX Q0874) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q0874) |
| 207Q00000X Family Medicine (Licence: TX 0040277) | |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2026-10-05 |