| NPI | 1912040288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CO 29045) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD24281) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2025-04-23 |