| NPI | 1992801682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60621126) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SD 5916) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2016-09-27 |