| NPI | 1225023187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 30352) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 170459-1) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2011-01-28 |