| NPI | 1740339761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 217874) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2000-00565) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2025-08-11 |