| NPI | 1902957046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX L1053) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11407064-1205) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2026-08-24 |