| NPI | 1083148456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0066724) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME143618) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2021-09-22 |