| NPI | 1134578222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61483214) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 1733) |
| 207Q00000X Family Medicine (Licence: NV DO2832) | |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2023-12-07 |