NPI | 1114676004 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP70013176) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 13516654-1204) |
Enumeration Date | 2022-03-20 |
Last Update Date | 2025-09-18 |