| NPI | 1194138578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 28919) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60750991) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2018-08-15 |