| NPI | 1336342930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60085553) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 5488) |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2021-04-29 |