| NPI | 1720128820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0040772) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CO 40772) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2021-06-21 |