| NPI | 1609216860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 61251875) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: WA 61251875) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2023-01-19 |