| NPI | 1952560179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60588585) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 13993) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2015-10-08 |