| NPI | 1700824570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD.MD.61431687) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036162442) |
| 207Q00000X Family Medicine (Licence: CO DR.0041015) | |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2026-08-18 |