| NPI | 1386870673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q1151) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301093903) |
| 207Q00000X Family Medicine (Licence: KY 45673) | |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2025-08-08 |