| NPI | 1932540242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61274094) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301109087) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2022-07-27 |