| NPI | 1780201780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V8613) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301508052) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2026-02-20 |