| NPI | 1568495455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 27571) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND 12316) |
| 207Q00000X Family Medicine (Licence: WA MD00037592) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2021-04-26 |