| NPI | 1154446300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60403555) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 235909) |
| 207Q00000X Family Medicine (Licence: CA A93083) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2025-01-17 |