| NPI | 1770694671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SD 4583) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00045666) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-01-14 |