| NPI | 1164584538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0049340) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD432256) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2013-11-20 |