| NPI | 1790968717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0060879) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 224698) |
| 207Q00000X Family Medicine (Licence: CA C152720) | |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2024-11-18 |