| NPI | 1609216753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 0058088) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 29046) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2020-03-16 |