| NPI | 1629413257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U3386) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT203886) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2025-12-15 |