| NPI | 1841276011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2004-01419) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 43518) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2021-05-11 |