| NPI | 1508394917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA op61078282) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA NA) |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2020-08-19 |