| NPI | 1154628527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 0010-02687) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-02687) |
| Enumeration Date | 2011-02-22 |
| Last Update Date | 2024-11-14 |