| NPI | 1558740175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 321633) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0060835) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2023-03-28 |