| NPI | 1144513250 |
|---|---|
| Former Name | GINA ANN MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD187492) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 3837) |
| 207Q00000X Family Medicine (Licence: CO 51731) | |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2021-02-11 |