| NPI | 1265877278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60587038) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60369155) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2026-01-13 |