| NPI | 1144751256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61335254) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD203985) |
| 207Q00000X Family Medicine (Licence: IL 036154635) | |
| 207Q00000X Family Medicine (Licence: SD 12158) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2025-09-23 |