| NPI | 1639279656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60485823) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD25285) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2015-11-12 |