| NPI | 1578570743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60952683) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101039112) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2025-03-06 |