| NPI | 1396937371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA BC60107719) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX No368) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2013-12-02 |