| NPI | 1932410107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60336434) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 4387) |
| Enumeration Date | 2010-06-23 |
| Last Update Date | 2021-06-10 |