| NPI | 1720017627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 87823) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 43371) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2022-09-28 |