| NPI | 1093128076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61593047) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M-15258) |
| 207Q00000X Family Medicine (Licence: MT 67042) | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2024-09-06 |