| NPI | 1558991687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NE 114160) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: CO APN.0995016-NP) |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2022-06-28 |