| NPI | 1770080087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP6160280) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A21524) |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2026-03-26 |