| NPI | 1962965038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ R77265) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0069342) |
| Enumeration Date | 2019-04-07 |
| Last Update Date | 2023-12-29 |