| NPI | 1215058904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60386218) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101017018) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2023-03-18 |