| NPI | 1942593587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60733286) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301098354) |
| 207Q00000X Family Medicine (Licence: OR MD165772) | |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2023-01-04 |