| NPI | 1356046163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101288421) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX V3274) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2026-08-31 |