| NPI | 1679553739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 01012557564) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 35538) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2022-03-10 |