| NPI | 1215371539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 5521) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R0689) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2025-07-17 |