| NPI | 1982925988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO 55769) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 47116) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2019-12-20 |