NPI | 1154854115 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0065928) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 306330) |
Enumeration Date | 2017-04-06 |
Last Update Date | 2021-07-28 |