| NPI | 1265054514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61341875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML61073964) |
| Enumeration Date | 2020-05-09 |
| Last Update Date | 2023-04-20 |