| NPI | 1457671547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60305710) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 270459) |
| Enumeration Date | 2010-06-11 |
| Last Update Date | 2020-07-28 |