| NPI | 1083776157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-13332) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 00029793) |
| 207Q00000X Family Medicine (Licence: WA WA0029793) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2017-02-20 |