| NPI | 1083652309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 55589) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 45332) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2018-05-11 |