| NPI | 1689867319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M6684) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 242069) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2025-12-16 |