| NPI | 1629073150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 40209) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM A-1212-03) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2008-05-29 |