| NPI | 1093125593 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 007391) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 00000000) | 
| Enumeration Date | 2014-05-06 | 
| Last Update Date | 2025-03-17 |