| NPI | 1083791941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME145161) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00044960) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-07-24 |