| NPI | 1760685804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX F7303) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: TX F7303) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2025-04-12 |