| NPI | 1578632469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD152532) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00047611) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2021-03-18 |