| NPI | 1972694438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M7875) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 91-146) |
| 207Q00000X Family Medicine (Licence: WA MD00038028) | |
| 207Q00000X Family Medicine (Licence: MO R8E66) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2016-03-08 |