| NPI | 1104353796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 174978) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: CO DR.0063003) | |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2022-03-21 |