| NPI | 1780110205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO198909) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60769782) |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2021-03-25 |