| NPI | 1366753352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60301823) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD160508) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2021-05-20 |