| NPI | 1194005066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 054681) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO2815) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2015-07-27 |