| NPI | 1831648401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61199762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60858574) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2021-08-31 |