| NPI | 1164818621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T8909) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.134888) |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2025-05-22 |