| NPI | 1104188598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60556572) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 04645) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2024-02-14 |