| NPI | 1235492596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60660062) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR pg169071) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2021-10-22 |