| NPI | 1932304367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 6131) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 70057034) |
| Enumeration Date | 2007-06-16 |
| Last Update Date | 2026-06-16 |