| NPI | 1912319914 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA 341365) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60666245) |
| 207Q00000X Family Medicine (Licence: CA A174485) | |
| Enumeration Date | 2014-05-24 |
| Last Update Date | 2024-06-20 |