| NPI | 1295463909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX W0629) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 50393) |
| Enumeration Date | 2022-08-10 |
| Last Update Date | 2025-09-26 |