| NPI | 1336137652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2013-00045) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 36476) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2018-06-21 |