| NPI | 1710942339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 7656A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 42461) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2013-02-19 |