| NPI | 1225030042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM md2005-0570) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 58066131205) |
| 207Q00000X Family Medicine (Licence: WA MD00044598) | |
| 207Q00000X Family Medicine (Licence: NM 2002R46) | |
| 207Q00000X Family Medicine (Licence: KS 31880) | |
| 207P00000X Emergency Medicine (Licence: TX N6302) | |
| 207Q00000X Family Medicine (Licence: TX N6302) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2018-01-29 |