| NPI | 1649998733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ND RL18458) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61642889) |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2025-07-16 |