| NPI | 1639585474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60782588) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO CDR.0001493) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2022-06-14 |