| NPI | 1184665697 |
|---|---|
| Former Name | CRYSTAL DAWNELLE POWELL; ASKEW; BONINO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 60959396) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0035551) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2019-10-11 |