| NPI | 1649247222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 43678) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 45032) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2014-12-09 |