| NPI | 1659563260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60006967) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A99231) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2025-08-07 |