| NPI | 1194920603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA WA MD60037565) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008776) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2021-05-11 |