| NPI | 1407236912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61085179) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL0005710) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2021-06-07 |