| NPI | 1518069897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00036661) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AK 4154) |
| 207Q00000X Family Medicine (Licence: IL 036081439) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2021-07-27 |