| NPI | 1144236753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60428756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM A-1189-02) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2016-06-15 |