| NPI | 1821390394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60576851) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A 11592) |
| Enumeration Date | 2010-12-03 |
| Last Update Date | 2021-05-12 |