| NPI | 1093945446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60658818) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 57610) |
| 207Q00000X Family Medicine (Licence: HI MD-214453) | |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2026-01-07 |