| NPI | 1962920603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO APN.0993366) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: CO APN.0993366) |
| Enumeration Date | 2017-09-01 |
| Last Update Date | 2017-09-01 |