| NPI | 1104576172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0074487) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ R80524) |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2025-07-06 |