| NPI | 1629145990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0057193) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2009012781) |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2016-07-12 |