| NPI | 1770595019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60077669) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008504) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2024-03-22 |