| NPI | 1144751611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 12898462-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD193528) |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2025-11-17 |