| NPI | 1376553040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 37530) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 80191) |
| 207Q00000X Family Medicine (Licence: OR MD23845) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2025-08-15 |