| NPI | 1255545786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60135278) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE TEP5595) |
| 363A00000X Physician Assistant (Licence: CA PA15763) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2024-04-10 |