| NPI | 1851853675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U5921) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A180724) |
| 207Q00000X Family Medicine (Licence: MO 2025003070) | |
| 207Q00000X Family Medicine (Licence: AZ 67162) | |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2026-09-23 |