| NPI | 1326043225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 252) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA54836) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2022-09-24 |