| NPI | 1548398282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 60012535) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 7616A) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2011-12-01 |