| NPI | 1720205479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 49079) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM MD2010-0044) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2016-11-23 |