| NPI | 1649596305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61670006) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX N5513) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2025-08-14 |