| NPI | 1740205780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 55955) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI MD-11164) |
| 207Q00000X Family Medicine (Licence: CA C54747) | |
| 207Q00000X Family Medicine (Licence: CO 0055110) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-02-03 |