| NPI | 1588824957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 52946) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 4045) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2021-06-21 |