| NPI | 1053363564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00028856) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M-8386) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-04-05 |