| NPI | 1003106402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-38364) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60475564) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2016-02-17 |