| NPI | 1831295161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD29317) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA ML20008600) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2012-07-31 |