| NPI | 1407593676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V8647) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 88136) |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2025-07-12 |