| NPI | 1780811398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 51605) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT196075) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2021-06-23 |