| NPI | 1073593281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2014-0493) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301078461) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2022-04-20 |