| NPI | 1265891436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61413204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 67042) |
| 207Q00000X Family Medicine (Licence: MI 5101024478) | |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2025-01-21 |