| NPI | 1629212295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60428752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2011-0765) |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2014-09-26 |