| NPI | 1376868224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60394364) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL1418) |
| 207Q00000X Family Medicine (Licence: ID O-0662) | |
| Enumeration Date | 2010-04-05 |
| Last Update Date | 2021-07-01 |