| NPI | 1184145112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V5330) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT212830) |
| 207Q00000X Family Medicine (Licence: MI 4301501315) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: TX V5330) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2026-05-21 |