| NPI | 1649840141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 81081) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10076994) |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2026-04-15 |