| NPI | 1306948591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2008-0635) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 37445) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2018-07-09 |