| NPI | 1861743379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR0053715) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11128880-1204) |
| 207Q00000X Family Medicine (Licence: WI 66304-21) | |
| 207V00000X Obstetrics & Gynecology (Licence: WI 66304-21) | |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2020-12-02 |