| NPI | 1922427624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 347305) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 260847) |
| 207Q00000X Family Medicine (Licence: NM MD2017-1000) | |
| 207Q00000X Family Medicine (Licence: TX R5761) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2026-06-16 |