| NPI | 1275113375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V2985) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: TX V2985) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2025-08-22 |