| NPI | 1154767069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care (Licence: HI MD-14101) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: HI MD14101) |
| 207Q00000X Family Medicine (Licence: HI MD14101) | |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2020-11-01 |