| 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 |