| NPI | 1942860994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61374305) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ND RL15725) |
| 207Q00000X Family Medicine (Licence: OR MD210121) | |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2025-08-01 |