| NPI | 1770795460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00049421) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008605) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2009-12-28 |