| NPI | 1528274511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-33124) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10021682) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2025-06-24 |