| NPI | 1235405986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2016-0619) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD173649) |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2024-10-05 |