| NPI | 1679979025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OL60577799) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: OR PG181124) | |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2017-04-12 |