| NPI | 1811456130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO219698) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL61161699) |
| Enumeration Date | 2019-03-16 |
| Last Update Date | 2024-09-30 |