| NPI | 1407887961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 48788) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM A-1214-03) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2014-11-12 |