| NPI | 1982226858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX U2875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 05-51755) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2026-01-11 |