| NPI | 1639707417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61325077) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: WA MD61325077) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2024-08-12 |