| NPI | 1578830402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P4148) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR0076233) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2025-11-14 |