| NPI | 1245272947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM A567-71) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB02875300) |
| 207Q00000X Family Medicine (Licence: CA 20A4585) | |
| 207Q00000X Family Medicine (Licence: CO 20827) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2015-04-06 |