| NPI | 1467891309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO CDR.0000292) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R74062) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2021-04-06 |