| NPI | 1902224736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0071838) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 34012538) |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2025-10-13 |