| NPI | 1043478993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60409811) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME MD28802) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2025-01-22 |