| NPI | 1699302174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.45781) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX U0378) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2025-03-11 |