| NPI | 1619222692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61020077) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WA OP6102077) |
| 207Q00000X Family Medicine (Licence: CO DR.0053095) | |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2026-02-19 |