| NPI | 1114316734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60658344) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A133492) |
| Enumeration Date | 2015-01-20 |
| Last Update Date | 2022-07-21 |