| NPI | 1992186720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 82630) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60842142) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2021-06-23 |