| NPI | 1134689995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61180673) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML6092130) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-01-08 |