NPI | 1619222692 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61020077) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0053095) |
Enumeration Date | 2012-07-17 |
Last Update Date | 2021-08-16 |