| NPI | 1366829855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61165530) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A151193) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2021-10-11 |