| NPI | 1164500047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD213637) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 51827) |
| 207Q00000X Family Medicine (Licence: GA 081044) | |
| 207Q00000X Family Medicine (Licence: OH 35.134628) | |
| 207Q00000X Family Medicine (Licence: CT 61671) | |
| 207Q00000X Family Medicine (Licence: TX L1220) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-07-24 |