| NPI | 1780869685 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N2266) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: TX N2266) |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2026-02-18 |