| NPI | 1730342585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 36388) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 54643) |
| 207Q00000X Family Medicine (Licence: TN 58432) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2021-07-28 |