| NPI | 1528422730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101267733) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60855797) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2020-01-28 |