| NPI | 1407419187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T2893) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2022035816) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2025-02-25 |