| NPI | 1710472279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61166424) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101023959) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2021-08-25 |