| NPI | 1164439956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2007-01205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01040575A) |
| 207Q00000X Family Medicine (Licence: CO DR0038403) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2021-04-02 |