| NPI | 1396039517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: NM MD2018-0642) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q2979) |
| 207Q00000X Family Medicine (Licence: NC 173099) | |
| 207QS0010X Family Medicine, Sports Medicine (Licence: TX Q2979) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2025-01-24 |