| NPI | 1306051453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301091033) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 43999) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2009-12-14 |