| NPI | 1417183179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60911951) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-17781) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2021-05-20 |