| NPI | 1295050128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0064009) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301102484) |
| 207Q00000X Family Medicine (Licence: WA Currently obtaining) | |
| Enumeration Date | 2010-04-04 |
| Last Update Date | 2020-03-10 |