| NPI | 1538115597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD21765) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00037323) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2022-02-04 |