| NPI | 1609807957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD202201120) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 38423) |
| 207Q00000X Family Medicine (Licence: AZ 15605) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2022-08-19 |