| NPI | 1205814167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60935786) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OPO60935786) |
| 207Q00000X Family Medicine (Licence: OR DO166249) | |
| 207Q00000X Family Medicine (Licence: CA 20A11678) | |
| Enumeration Date | 2006-01-02 |
| Last Update Date | 2021-11-09 |