| NPI | 1497263438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA PA61018533) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1931) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2020-02-20 |