| NPI | 1396831178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR OR MD19137) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00029505) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |