| NPI | 1285862516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60468627) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101018120) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2022-07-21 |