| NPI | 1255864906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV DO3569) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS17069) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2024-03-01 |