| NPI | 1508168758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0056108) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A11477) |
| 207Q00000X Family Medicine (Licence: FL OS11648) | |
| Enumeration Date | 2010-11-20 |
| Last Update Date | 2016-05-13 |