| NPI | 1912249384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61399239) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A141776) |
| 207Q00000X Family Medicine (Licence: TX T5646) | |
| 207Q00000X Family Medicine (Licence: FL ME154627) | |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2023-08-04 |