| NPI | 1861011660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0067497) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101028752) |
| Enumeration Date | 2020-04-11 |
| Last Update Date | 2025-09-15 |