| NPI | 1720039548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA PP3256) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 43674) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2015-02-12 |