| NPI | 1538517693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60918873) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60659047) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2021-04-05 |