| NPI | 1033647938 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61226410) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60850067) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-23 | 
| Last Update Date | 2025-01-03 |