| NPI | 1093021925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61351968) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 281861) |
| 207Q00000X Family Medicine (Licence: TX Q7728) | |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2024-01-19 |