| NPI | 1295777886 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 36180)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 011405)  | 
| Enumeration Date | 2006-06-11 | 
| Last Update Date | 2025-08-13 |