| NPI | 1467746826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA IMLC.MD.61231879) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 55248) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2021-11-03 |