| NPI | 1073009023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61165825) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 8314) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2025-01-10 |