| NPI | 1144420787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR0053047) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM A-1644-11) |
| 207Q00000X Family Medicine (Licence: MI 5101018928) | |
| 207Q00000X Family Medicine (Licence: ME T0753) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-11-04 |