| NPI | 1386698744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M9177) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60053286) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2022-03-21 |