| NPI | 1417307349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61402153) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 0685) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2023-10-16 |