| NPI | 1114079357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00045489) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A87149) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2013-03-04 |