| NPI | 1902191240 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX P9786)  | 
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: TX P9786)  | 
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: TX P9786)  | |
| Enumeration Date | 2011-06-15 | 
| Last Update Date | 2023-12-07 |