| NPI | 1831354521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: WA MD00045438) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00045438) |
| 171W00000X Contractor (Licence: CA A93711) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2012-06-20 |