| NPI | 1952742850 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0065112) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R9876) |
| 207Q00000X Family Medicine (Licence: AZ 51676) | |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2020-10-30 |