| NPI | 1770529380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 80-45) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 23974) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2009-06-11 |