| NPI | 1184079485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S7835) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 298154) |
| Enumeration Date | 2016-04-25 |
| Last Update Date | 2026-05-13 |