| NPI | 1790105518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.147511) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR0056005) |
| 207Q00000X Family Medicine (Licence: ID M13533) | |
| 207Q00000X Family Medicine (Licence: ID M-13533) | |
| Enumeration Date | 2014-04-19 |
| Last Update Date | 2023-07-28 |