| NPI | 1356310601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD150056) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47401) |
| 207Q00000X Family Medicine (Licence: WA MD60651584) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2026-03-11 |