| NPI | 1780114074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX W2761) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 324261) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2026-08-05 |