| NPI | 1104316603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI 4301518399) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX S4738) |
| 207Q00000X Family Medicine (Licence: TX S4738) | |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2026-08-21 |