| NPI | 1720053093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00038319) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101231163) |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2008-11-26 |