| NPI | 1194562231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA ML61571942) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML.61571942) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2024-08-09 |