| NPI | 1194708446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60447556) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 27185) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2015-10-27 |