| NPI | 1629394127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60529771) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD163908) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2021-05-18 |