| NPI | 1831530195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60574523) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML 60377109) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2021-03-24 |