| NPI | 1548260052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2004-0636) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A92197) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2014-11-13 |