| NPI | 1346515806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60783779) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO3297) |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2018-04-02 |