| NPI | 1689060584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60855199) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM R-08-2015) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2018-09-14 |