| NPI | 1972588820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD 60295586) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA G61561) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2014-05-28 |