| NPI | 1184966707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60572762) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A141785) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2021-08-02 |