| NPI | 1760902449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 58966) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10059404) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2025-07-08 |