| NPI | 1992361117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61183821) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60958282) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2022-07-25 |