| NPI | 1598058711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-12914) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60224509) |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2021-05-20 |