| NPI | 1134878689 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 86821-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX W1753) |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2026-01-15 |