| NPI | 1811239965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60646501) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60646501) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2020-12-04 |