| NPI | 1376807727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO CDRH.0000552) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 71682) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2025-04-28 |