| NPI | 1861885717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO196666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP60901786) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2021-03-15 |