| NPI | 1679654412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD152954) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 43936) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2021-03-22 |