| NPI | 1942286596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD27541) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 40801) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2025-06-23 |