| NPI | 1891805040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 0062449) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD60479838) |
| 207Q00000X Family Medicine (Licence: CA A64937) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-10-21 |