| NPI | 1477050466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61142236) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PG188309) |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2025-01-27 |