| NPI | 1568816569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60935292) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R75473) |
| Enumeration Date | 2016-04-16 |
| Last Update Date | 2021-06-04 |