| NPI | 1477582062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 78264) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M1040) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2026-04-15 |