| NPI | 1699978940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2013-0579) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35-092727) |
| 207Q00000X Family Medicine (Licence: WA 60218123) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2013-08-01 |