| NPI | 1750957791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX v3237) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2025011182) |
| Enumeration Date | 2021-06-01 |
| Last Update Date | 2025-04-11 |