| NPI | 1518940931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 60180416) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 38267) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2018-04-18 |