| NPI | 1639708324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD219804) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD.615698812) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2024-10-21 |