| NPI | 1679005623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61186922) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO205918) |
| 207Q00000X Family Medicine (Licence: NC 227652) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2025-05-23 |