| NPI | 1598111833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX S9475) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 292883) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2025-08-22 |