| NPI | 1114192432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 53684) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 243264) |
| 207Q00000X Family Medicine (Licence: OH 35-09165) | |
| 207Q00000X Family Medicine (Licence: CA A110209) | |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2015-01-09 |