| NPI | 1912680331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX W9179) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 48872) |
| 207Q00000X Family Medicine (Licence: TX 48105) | |
| 207Q00000X Family Medicine (Licence: TX 48467) | |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2026-09-15 |