| NPI | 1164872032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 0062995) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PG178689) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2019-10-17 |