| NPI | 1407077134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101251754) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00048022) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2013-04-08 |