| NPI | 1205858123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: WA MD00035217) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00035217) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2020-05-12 |