| NPI | 1124382676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60490100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60293604) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2020-10-07 |