| NPI | 1235571993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 80538) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD 60587328) |
| 207Q00000X Family Medicine (Licence: AK ML 113855) | |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2019-12-06 |