| NPI | 1942242821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 45577) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 2003-0162) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2021-06-19 |