| NPI | 1306973979 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 23624)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX M9065)  | 
| 207Q00000X Family Medicine (Licence: WY 10309A)  | |
| 207Q00000X Family Medicine (Licence: CO DR.0057992)  | |
| Enumeration Date | 2007-02-28 | 
| Last Update Date | 2023-07-03 |