| NPI | 1154749398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60677997) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60677997) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2019-04-29 |