| NPI | 1124015433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60200769) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD153026) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2021-07-02 |