| NPI | 1285635086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60119145) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR DO25860) |
| 207Q00000X Family Medicine (Licence: ID O-364) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2010-11-02 |