| NPI | 1386677722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-10915) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD000637598) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2015-08-18 |