| NPI | 1902028079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 52666) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA md00046947) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2017-03-09 |