| NPI | 1801137633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TN 3883) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0057082) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2020-03-20 |