| NPI | 1467895631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60790002) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD D82096) |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2021-05-11 |