| NPI | 1245483478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 50521) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD 60140024) |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2011-11-28 |