| NPI | 1568490340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-14604) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00041706) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: WA MD00041706) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2019-07-17 |