| NPI | 1164771077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q1110) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT190238) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2026-02-03 |