| NPI | 1417132804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60379051) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 68262701205) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2017-10-24 |