| NPI | 1063161883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 77380) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 207Q00000X Family Medicine (Licence: OR MD219064) | |
| Enumeration Date | 2022-03-20 |
| Last Update Date | 2025-10-07 |