| NPI | 1982830162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 0049519) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT 19954) |
| 207Q00000X Family Medicine (Licence: OR MD166960) | |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2022-07-21 |