| NPI | 1811033970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00021827) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA AH2809880) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2008-05-12 |