| NPI | 1396273066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX BP10059384) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX R8860) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2025-11-11 |