| NPI | 1871516393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD6164852) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 32249) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2025-04-17 |