| NPI | 1508924564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NH MD00016256) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00037690) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2023-07-05 |