| NPI | 1821582313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61247959) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-09637) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2022-02-07 |