| NPI | 1811041122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 37386) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 2286) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2013-10-04 |