| NPI | 1457405953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 43025) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00045349) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2017-03-29 |