| NPI | 1730318999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60412262) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2009018426) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2021-06-24 |