| NPI | 1396182267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60577167) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60375676) |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2021-02-18 |