| NPI | 1215319025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U8559) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A155857) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2025-12-04 |