| NPI | 1871933796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD195019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61059756) |
| 207Q00000X Family Medicine (Licence: NE 28039) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2022-02-01 |