| NPI | 1841851987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61402271) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4351044875) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2023-04-11 |