| NPI | 1528124120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR DO152573) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP00002096) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2011-09-01 |