| NPI | 1518969575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: FL ME161192) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 136291) |
| 207Q00000X Family Medicine (Licence: MO 113071) | |
| 207Q00000X Family Medicine (Licence: WA MD60776458) | |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2023-06-28 |