| NPI | 1649596552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO202063) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 271133) |
| 207Q00000X Family Medicine (Licence: WA OP61126442) | |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2026-07-02 |