| NPI | 1295769446 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP00001379)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 5527655-1204)  | 
| Enumeration Date | 2006-07-11 | 
| Last Update Date | 2014-03-19 |