| NPI | 1154618882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 83843) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP60524953) |
| 207Q00000X Family Medicine (Licence: SD 8612) | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2024-01-15 |