| NPI | 1003430760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 332044) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61403769) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2025-09-11 |