| NPI | 1457626905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 52684) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0065761) |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2021-07-21 |