| NPI | 1164870002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0062313) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO TL.0006222) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2021-06-15 |