| NPI | 1497047161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60395242) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101256252) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2021-04-26 |