| NPI | 1245439801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 50734) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 239614) |
| 207Q00000X Family Medicine (Licence: CT 048453) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2021-05-10 |