| NPI | 1063903623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0065885) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 8244) |
| Enumeration Date | 2018-05-19 |
| Last Update Date | 2021-08-06 |