| NPI | 1700052735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60084571) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 43565) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2021-04-27 |