| NPI | 1609915636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 7230) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0054942) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2021-06-22 |