| NPI | 1487044640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO CDRH.0057175) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T6143) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2024-08-14 |