| NPI | 1801094966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301089804) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60170872) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2013-10-14 |