| NPI | 1194072470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 0054229) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 4437) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2021-05-04 |