| NPI | 1407877038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 45889) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 057705) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2018-11-05 |