| NPI | 1063850998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0057419) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0116026022) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2021-04-07 |