| NPI | 1336139534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0056781) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101012799) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2017-04-10 |