| NPI | 1073752606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60173886) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML 60020210) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2023-02-15 |