| NPI | 1588221642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OL60971094) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO209478) |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2025-09-18 |