| NPI | 1710330774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0062795) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL39797) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2019-08-07 |