| NPI | 1922662394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX T9151) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T9151) |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2025-06-17 |