| NPI | 1659546265 |
|---|---|
| Former Name | MIRIAM GRACE SPARKMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 49399) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A116454) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2014-03-11 |