| NPI | 1356862346 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61619513) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 306568) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2025-07-01 |