| NPI | 1346412079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 60784868) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2021029615) |
| 207Q00000X Family Medicine (Licence: AZ 005296) | |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2023-02-07 |