| NPI | 1184823403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60323387) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 60323387) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2019-08-14 |