| NPI | 1790210847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61072463) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR 183283) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2020-11-09 |