| NPI | 1942822531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61529950) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 38163) |
| Enumeration Date | 2020-05-18 |
| Last Update Date | 2024-06-12 |