| NPI | 1649520313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OL60967744) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO208276) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2025-01-24 |