| NPI | 1336725704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61461671) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD H0105397) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2026-01-21 |