| NPI | 1790218808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 91176) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0061178) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2022-02-14 |