| NPI | 1932785862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101286289) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX V3112) |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2025-09-11 |