| NPI | 1922483775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60846708) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 7541) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2019-08-14 |