| NPI | 1982133096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX V9883) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A162960) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2025-09-03 |