| NPI | 1770013005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61097599) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: WA MD61097599) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2025-01-18 |