| NPI | 1306462809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4351046054) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61403865) |
| Enumeration Date | 2020-06-19 |
| Last Update Date | 2023-07-06 |