| NPI | 1891868097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60159652) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID 9871166) |
| 207Q00000X Family Medicine (Licence: IA 3014) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2025-09-04 |