| NPI | 1528210838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME154970) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60945861) |
| 207Q00000X Family Medicine (Licence: MI 4301088426) | |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2026-03-19 |