| NPI | 1598790503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX Q4985) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101231445) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2025-11-18 |