| NPI | 1730261751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00043984) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A96956) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2011-08-30 |