| NPI | 1306871603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60322730) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 23908) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2013-03-25 |