| NPI | 1790763282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60611291) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD24750) |
| 207Q00000X Family Medicine (Licence: TX P1479) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2016-02-25 |