| NPI | 1669884664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60660079) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML 60471466) |
| Enumeration Date | 2014-05-24 |
| Last Update Date | 2023-06-15 |