| NPI | 1659716785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60891447) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML60703552) |
| 207Q00000X Family Medicine (Licence: AK 140686) | |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2022-04-14 |