| NPI | 1609458850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA md61535779) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PG205095) |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2026-06-19 |