| NPI | 1659377521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0057718) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2005-0310) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2022-07-21 |