| NPI | 1154307338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 21688) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 43765) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2015-03-16 |