| NPI | 1912065285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI 16197) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101238475) |
| 207Q00000X Family Medicine (Licence: CO 38167) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2012-10-31 |