| NPI | 1285734491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY TL5911) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 35070) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2019-10-09 |