| NPI | 1225521016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V8887) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: TX V8887) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2026-08-01 |