| NPI | 1891994703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WY 6760A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 38966) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2022-04-28 |