| NPI | 1265938021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61321225) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PENDING) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2026-08-24 |