| NPI | 1336137868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60262025) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47947-020) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2020-02-26 |