| NPI | 1972705879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX M7669) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00047274) |
| Enumeration Date | 2007-06-03 |
| Last Update Date | 2025-02-11 |