| NPI | 1124119359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD162578) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60226753) |
| 208D00000X General Practice (Licence: WA MD60226753) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2014-08-07 |