| NPI | 1942821848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 61447717) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR 216483) |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2025-03-27 |