| NPI | 1265450324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00041346) |
| Additional Taxonomies | 208D00000X General Practice (Licence: LA MD.200509) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2009-11-25 |