| NPI | 1639791718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61314799) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL61073038) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2023-07-20 |