| NPI | 1245659788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60778565) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60481512) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2022-07-21 |