| NPI | 1174638563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD26414) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00023240) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2009-01-12 |