| NPI | 1376276840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61638160) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM RS2022-0949) |
| Enumeration Date | 2022-07-02 |
| Last Update Date | 2025-11-14 |