| NPI | 1750309399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM CNP00905) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM R40537) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-12-30 |