| 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 | 2021-06-01 |