| NPI | 1790195295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 78351) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T7122) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2025-11-06 |