| NPI | 1902845522 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 60391920) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301077612) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2016-03-30 |