| NPI | 1508949439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 7602) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00044274) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-10-02 |