| NPI | 1053547232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60368373) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL-3267) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2020-10-19 |