| NPI | 1114149853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A12134) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP 60006013) |
| 207Q00000X Family Medicine (Licence: HI DOS1421) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2025-09-09 |