| NPI | 1487220125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.73265) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 196-T2) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2024-12-02 |