| NPI | 1588862098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60151452) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO217743) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2025-09-20 |