| NPI | 1578739967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP60231136) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 35427) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2013-02-18 |