| NPI | 1275776080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00034147) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD29134) |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2025-12-05 |