| NPI | 1689636011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 42993) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID M-9632) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2025-07-23 |