| NPI | 1174899157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD 00026412) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G54010) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2012-03-23 |