| 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 | 2024-09-17 |