| NPI | 1427021690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60105291) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 1150) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-05-20 |