| NPI | 1790344794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61253922) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV LL3261) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2023-11-07 |