| NPI | 1689812570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60549019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A106583) |
| 207Q00000X Family Medicine (Licence: RI MD13304) | |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2016-02-25 |