| NPI | 1679566111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD212644) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 47999) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2023-03-07 |