| NPI | 1629058524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00028589) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00028589) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2021-07-29 |