| NPI | 1457465254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 38811) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA MD00046255) |
| 207Q00000X Family Medicine (Licence: NM MD20060266) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2011-06-17 |