| NPI | 1326290628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101017650) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP60237212) |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2021-06-04 |