| NPI | 1598753782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2007-0780) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 41258) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2015-03-28 |