| NPI | 1578121042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 27505) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61178950) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2025-08-07 |