| NPI | 1962668772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60145550) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 4671) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2011-03-24 |