| NPI | 1699160457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 83270) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0057478) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2021-06-16 |