| NPI | 1982999322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD 60224198) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD169271) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2022-07-25 |