| NPI | 1801882881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M7054) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00036315) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2011-07-21 |