| NPI | 1972009314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-42839) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD61155082) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2023-08-07 |