| NPI | 1568457968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L2394) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61367487) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2025-04-29 |