| NPI | 1417169277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00048260) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20007828) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-12-04 |