| NPI | 1972619930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD00036737) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA 00036737) |
| 207Q00000X Family Medicine (Licence: CO 43077) | |
| 207Q00000X Family Medicine (Licence: CO DR0043077) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2025-08-14 |