| NPI | 1104811470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 15497) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0049556) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2023-10-11 |