| NPI | 1639564164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: DC MD047731) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 65025) |
| 207Q00000X Family Medicine (Licence: WA MD60748512) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2023-03-07 |