| NPI | 1164866083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61420319) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX Q5036) |
| 207Q00000X Family Medicine (Licence: NY 304543) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2023-07-17 |