| NPI | 1760010482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61318145) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 1015514) |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2024-07-12 |