| NPI | 1538573217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 0059149) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 9408353) |
| 207Q00000X Family Medicine (Licence: NE 31817) | |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2023-01-31 |