| NPI | 1578903373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60951005) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A134159) |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2019-08-19 |