| NPI | 1346232592 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO MD2002022546)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 0000747)  | 
| 207Q00000X Family Medicine (Licence: MO 2002022546)  | |
| 207Q00000X Family Medicine (Licence: AZ 61535)  | |
| 207Q00000X Family Medicine (Licence: KS 0441013)  | |
| Enumeration Date | 2005-08-15 | 
| Last Update Date | 2023-04-05 |