| NPI | 1730612508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: WA OP61070926) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP61070926) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2025-01-15 |