| NPI | 1295398667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS20487) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP61306404) |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2024-01-22 |