| NPI | 1871081133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101287018) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T2770) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2025-11-06 |