| NPI | 1235339359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60090609) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008540) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2015-01-17 |