| NPI | 1225321748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME114065) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 51827) |
| 207Q00000X Family Medicine (Licence: AR E11135) | |
| 207Q00000X Family Medicine (Licence: NC 2018-00073) | |
| 207Q00000X Family Medicine (Licence: KY 51039) | |
| 207Q00000X Family Medicine (Licence: GA 080003) | |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2019-12-26 |