| NPI | 1124258876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60238358) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0052409) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2022-12-19 |