| NPI | 1740923762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V9177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10078458) |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2025-09-25 |