| NPI | 1811308893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60829070) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R74527) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2018-10-11 |