| NPI | 1821316787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U5840) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35120627) |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2025-05-31 |