| NPI | 1750467312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD172747) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 40029) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2017-03-03 |