| NPI | 1427156165 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60600589) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-30565) |
| 207Q00000X Family Medicine (Licence: ID M11053) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-06-18 |