| NPI | 1174552517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV DO2654) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL MEOS0007119) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2022-10-18 |