| NPI | 1235417544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 009329) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO DR.0067490) |
| 207Q00000X Family Medicine (Licence: TX T7174) | |
| 207Q00000X Family Medicine (Licence: CA 12568) | |
| Enumeration Date | 2011-08-03 |
| Last Update Date | 2026-06-08 |