| NPI | 1114306644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60828698) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1480) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2018-08-07 |