| NPI | 1902391964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V5290) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301115880) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2025-01-03 |