| NPI | 1225073158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD212492) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00045574) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2023-02-21 |