| NPI | 1548298482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 054242) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 48467) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2021-06-16 |