| NPI | 1093155640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 290316) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0057626) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2024-11-12 |