| NPI | 1134792310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND RL17359) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61527902) |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2024-07-02 |