| NPI | 1568787463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO-06577) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 4429) |
| 207Q00000X Family Medicine (Licence: OR DO176355) | |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2025-01-10 |