| NPI | 1366931644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61560853) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD202354) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2024-08-08 |