| NPI | 1093874901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR OR MD22946) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA WA MD00039607) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |