| NPI | 1821277104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60156343) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008880) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2023-07-18 |