| NPI | 1831832591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX W0695) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PG211223) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2025-09-03 |