| NPI | 1811954829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00041782) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C54129) |
| 207Q00000X Family Medicine (Licence: OR MD27702) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2021-08-05 |