| NPI | 1023014925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60591859) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 083109) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2021-03-01 |