| NPI | 1154768075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD223258) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61637342) |
| 207Q00000X Family Medicine (Licence: AZ 56616) | |
| 207Q00000X Family Medicine (Licence: CA A132221) | |
| Enumeration Date | 2013-06-01 |
| Last Update Date | 2025-11-13 |