| NPI | 1457613770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60456733) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OL60286796) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2021-04-07 |