| NPI | 1184612962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60126252) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO27966) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2017-08-28 |