| NPI | 1396768412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00041639) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 53948) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2024-05-30 |