| NPI | 1366857369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 339203) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO214286) |
| 207Q00000X Family Medicine (Licence: WI 69873) | |
| 207Q00000X Family Medicine (Licence: AK 8309) | |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2024-12-02 |