| NPI | 1104489475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GU MC294) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T6367) |
| 207Q00000X Family Medicine (Licence: CA 178769) | |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2025-05-19 |