| NPI | 1265870430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR 176018) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP 60637961) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2022-02-04 |