| NPI | 1326195629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00049240) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 37451) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2019-12-11 |