| NPI | 1609036771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60155804) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD183825) |
| 207Q00000X Family Medicine (Licence: OH 57.012943) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2018-03-17 |