| NPI | 1902034341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD2012-0006) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM RS2009-0405) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2013-02-28 |