| NPI | 1952720575 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2020029415)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0056816)  | 
| Enumeration Date | 2014-04-10 | 
| Last Update Date | 2024-05-02 |