| NPI | 1639439474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60465047) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60288823) |
| Enumeration Date | 2012-05-28 |
| Last Update Date | 2025-01-17 |