| NPI | 1891085759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0055670) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX P7648) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2015-09-11 |