| NPI | 1417651340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX W6327) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 14151539-1205) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2026-08-11 |