| NPI | 1609166065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 277119) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U7647) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2026-02-02 |