| NPI | 1588915896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD186849) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60558904) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2019-11-12 |