| NPI | 1649414384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00039409) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ZZ 78391) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2009-04-24 |