| NPI | 1750802096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61389596) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 009014) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2023-06-08 |