| NPI | 1821249624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 50306) |
| Additional Taxonomies | 208600000X Surgery (Licence: MT 11886) |
| 208600000X Surgery (Licence: CO 50306) | |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2016-02-29 |