| NPI | 1265567952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 30294) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI 10959) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2017-11-09 |