| NPI | 1790931624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N6374) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CA CA20575) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2026-07-27 |