| NPI | 1134612658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: WA MD61578051) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD201627) |
| Enumeration Date | 2018-06-09 |
| Last Update Date | 2024-09-05 |