| NPI | 1790071835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16999) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0059991) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2024-06-17 |