| NPI | 1053464396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD24566) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00044847) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-10-02 |