| NPI | 1124354030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60233372) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML 60106813) |
| Enumeration Date | 2009-10-28 |
| Last Update Date | 2021-08-05 |