| NPI | 1588958599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60408626) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60231342) |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2020-10-07 |