| NPI | 1578120630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO211572) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60967838) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2023-02-10 |