| NPI | 1952891947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61199866) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1724) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2023-11-01 |