| NPI | 1811262975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0055834) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125.061221) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2020-02-24 |