| NPI | 1053163931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO PA0008711) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO INPROCESS) |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2025-05-21 |