| NPI | 1861439770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60026899) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 5169A) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2021-04-29 |