| NPI | 1255692976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60467082) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60290887) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2021-12-15 |