| NPI | 1568532372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 36504) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60136339) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2021-06-04 |