| NPI | 1457700908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0062958) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS15945) |
| 207Q00000X Family Medicine (Licence: ME LT20050) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2022-12-06 |