| NPI | 1508022955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S0894) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL10961) |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2025-07-08 |