NPI | 1104139054 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0059492) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60302124) |
Enumeration Date | 2010-07-21 |
Last Update Date | 2021-04-20 |