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 |