| NPI | 1649201872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00022040) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: WA MD00022040) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2021-08-17 |