| NPI | 1386729622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2013-0611) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00033275) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2015-01-29 |