| NPI | 1205871803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L1379) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 66130) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2026-04-30 |