| NPI | 1639306509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0074042) |
| Additional Taxonomies | 208600000X Surgery (Licence: HI MDR-5741) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0008850) | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2024-12-17 |