| NPI | 1699764472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00040797) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0067610) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2022-04-14 |