| NPI | 1295174977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 191665) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60658356) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2021-02-25 |