| NPI | 1477074532 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP1060215) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT017612) |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2026-06-17 |