| NPI | 1356787451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA ML60371046) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML 60371046) |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2021-03-09 |