| NPI | 1093079527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60489935) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA Ml60293649) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2021-05-06 |