| NPI | 1215982798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 35697) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 10099) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2011-01-04 |