| NPI | 1528642782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61548759) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT222802) |
| Enumeration Date | 2021-05-12 |
| Last Update Date | 2026-04-22 |