NPI | 1740635416 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO CDRH.0062164) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO Cdrh.0062164) |
Enumeration Date | 2016-04-29 |
Last Update Date | 2024-12-19 |