| NPI | 1053522284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60014633) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008809) |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2017-03-15 |