| NPI | 1982014007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61086101) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 269650) |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2021-02-01 |