| NPI | 1659526473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD154572) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60454270) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2023-04-26 |