| NPI | 1871938894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60574099) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60369013) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2021-05-10 |