| NPI | 1255536090 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60595416)  | 
| Additional Taxonomies | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: CA A107107)  | 
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: WA MD60595416)  | |
| 208600000X Surgery (Licence: WA MD60595416)  | |
| 2086S0129X  (Licence: MI 4301103957)  | |
| 2086S0129X  (Licence: PA MD455337)  | |
| 2086S0129X  (Licence: WA MD60595416)  | |
| Enumeration Date | 2007-06-20 | 
| Last Update Date | 2025-06-19 |