| NPI | 1770930406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60869840) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60661867) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2022-02-08 |