| NPI | 1881855989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MT 12694) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP60195450) |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2012-03-19 |