| NPI | 1598041022 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U7249)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 263122)  | 
| 207Q00000X Family Medicine (Licence: NV 14598)  | |
| Enumeration Date | 2011-10-28 | 
| Last Update Date | 2024-10-01 |