| NPI | 1124291547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 49479) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 2654) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2023-06-01 |