| NPI | 1154778223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61153958) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT MED-PHYS-LIC-80432) |
| 207Q00000X Family Medicine (Licence: FL ME143056) | |
| 207Q00000X Family Medicine (Licence: IN 01084505A) | |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2022-09-16 |