| NPI | 1982965794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME DO2610) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP60562552) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2020-09-24 |