| NPI | 1467947507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0065801) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL UO6188) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2021-05-13 |