| NPI | 1215590021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61282182) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R3142) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2022-08-25 |