| NPI | 1639161409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0059664) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD-062920-L) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2021-09-13 |