| NPI | 1013018019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00047375) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 24101) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-11-12 |