| NPI | 1831380195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX R5022) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 52854) |
| 207Q00000X Family Medicine (Licence: CO 52993) | |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2022-02-23 |