| NPI | 1518609726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 14256473-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R99999) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2026-07-27 |