| NPI | 1962104299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO TL.0009569) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CO DR.0073796) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0009569) | |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2024-09-26 |