| NPI | 1225054646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD26408) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 33275) |
| 207Q00000X Family Medicine (Licence: HI 19947) | |
| 207Q00000X Family Medicine (Licence: WA MD606724) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2021-12-28 |