| NPI | 1831127018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 64823) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD219603) |
| 207Q00000X Family Medicine (Licence: NV 15094) | |
| 207Q00000X Family Medicine (Licence: MI 4301076269) | |
| 207Q00000X Family Medicine (Licence: CA C56175) | |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2025-11-21 |