| NPI | 1740497601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0066741) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T4422) |
| 208D00000X General Practice (Licence: MD D0066741) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2026-06-09 |