| NPI | 1306227970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60676912) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60563695) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2018-07-17 |