| NPI | 1366417966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0036358) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 10408A) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-06-12 |