| NPI | 1457548760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 8479A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008891) |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2011-11-19 |