| NPI | 1265675508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60233140) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60095637) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2023-03-07 |