| NPI | 1417449885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 64059) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10062854) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2025-12-01 |