| NPI | 1669820080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO193262) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP60946753) |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2023-09-05 |