| NPI | 1396279246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD201849) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL.0006469) |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2020-12-01 |