| NPI | 1053756999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2022048028) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60670414) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2023-03-21 |