| NPI | 1265307938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: TX 1215375) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 1215375) |
| Enumeration Date | 2025-10-10 |
| Last Update Date | 2026-05-11 |