| NPI | 1568889855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60910645) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME119013) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2021-11-08 |