| NPI | 1922151612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00039154) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA C53440) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2014-12-19 |